About 14 years ago a group of software developers got together at a ski resort in the US to find an alternative to the top-down, over-bureaucratic and over-documented approaches to software development that were a feature of programming at the time. Many of them were already 'insurgents' experimenting with new development techniques that were better suited to the rapidly changing technology landscape.

Out of this came a bigger, international, gathering of like-minded individuals and the development of the Agile Manifesto. This was the beginning of a movement that in time has seen the development of methodologies that have transformed the time it takes to get software from concept to delivery and that have transformed the pace at which software is updated and released.

I have translated the manifesto (it was not difficult) into an Agile Manifesto for NHS 'improvers'

I have been working in quieter moments to begin to translate those original Agile concepts and methodologies to the world of service improvement within the NHS. As part of this I assembled a number of bits of a jigsaw to help me 'triangulate' and then sketched out the bones of the idea on a whiteboard. Three other images form part of the jigsaw with thanks to @PaulBromford (Paul Taylor at Bromford labs) for the Tests and Pilots diagram and @whatsthepont (Chris Bolton) and to IHI amongst many others for the Model for Improvement.